The existing health thread is for discussion on how changes to current policy will/have personally affected you or those you know. This thread is for more general discussion of the subject.
They have dug their own grave, here.
Only in a world where people actually think about what they're being told.
In Trump's America, they'll increase the chocolate ration to 3.5 grams from 5 grams, and their voters will cheer.
To all those Trump supporters who voted to end "Obamacare" not realizing that their ACA enrollment WAS "Obamacare", to all those Trump supporters who sincerely thought that Mexico would pay for the wall, to all the Trump supporters who were serious about "draining the swamp", to all the Trump supporters who thought manufacturing jobs were coming back...
All I can picture is Ultron saying "You'll catch on".
The report estimates that the number of uninsured would increase by 18 million in the first year. After the elimination of Medicaid eligibility and subsidies for insurance bought through the exchanges kicks in, that number would increase to 27 million and hit 32 million by 2026.
Premiums for individual policies bought through the exchanges (or directly from insurers) would increase 20 to 25 percent the first year. That increase would reach about 50 percent the year after Medicaid expansion and subsidies are eliminated. Health insurance premiums would about double by 2026.
Ryan has already come out and says those numbers are bunk because it does not take into account the replacement plan.
Well, where the fudge is this replacement plan at?
Ryan has already come out and says those numbers are bunk because it does not take into account the replacement plan.
Well, where the fudge is this replacement plan at?
The CBO is already ahead of him.
Back in December they published several memos describing how they were going to deal with the inevitable repeal of Obamacare.
First, they established a clear definition of what they considered private health insurance:
Health insurance policies vary widely, ranging from some that offer substantial coverage for a variety of health care services to some with a limited scope or amount of coverage. Therefore, in preparing any estimate of the number of people covered by health insurance, it is useful and important to identify where to draw the line to distinguish policies that provide some type of comprehensive coverage from those that do not.
An important function of insurance is to provide financial protection against high-cost, low-probability events. Consistent with that notion, CBO broadly defines private health insurance coverage as a comprehensive major medical policy that, at a minimum, covers high-cost medical events and various services, including those provided by physicians and hospitals. The agency grounds its coverage estimates on that widely accepted definition, which encompasses most private health insurance plans offered in the group and nongroup markets. The definition excludes policies with limited insurance benefits (known as “mini-med” plans); “dread disease” policies that cover only specific diseases; supplemental plans that pay for medical expenses that another policy does not cover; fixed-dollar indemnity plans that pay a certain amount per day for illness or hospitalization; and single-service plans, such as dental-only or vision-only policies.
...
If the provisions of the ACA governing the definition of private insurance coverage were repealed, CBO would revert to the broader definition of private insurance coverage—a comprehensive major medical policy, as described above. Such a broad definition of private insurance coverage is in keeping with what the agency has used to estimate coverage in the past. For a discussion of how CBO would estimate coverage under alternative proposals, see CBO’s blog post about challenges in estimating health insurance coverage under proposals for refundable tax credits.
Then the agency acknowledged that any replacement plans coming out of the Republican-controlled Congress would likely be high cost/low benefit garbage so it isn't going to count people receiving tax credits for those plans as having health insurance coverage. They'll just be counted as receiving a tax credit.
In response to a future policy that had minimal federal or state regulations, CBO and JCT expect that some new insurance products would be offered that limited coverage to the amount of the tax credit. Some of those insurance products purchased by people using a tax credit would probably not offer much financial protection against high out-of-pocket costs. Depending on the size of the tax credit, however, the depth and extent of coverage and the premiums of plans could vary. As discussed in another blog post about how CBO defines and estimates coverage, CBO does not count plans that have very limited benefits in measuring the extent of private insurance coverage; in such an assessment, it counts only people with a comprehensive major medical policy as having private insurance.
Under such proposals, CBO and JCT would separately estimate the number of people who would receive the tax credits and, if policymakers expressed interest in such estimates, the number of people who would purchase private insurance in the nongroup market that met a broad definition of coverage. In that case, the latter estimate of the number of people with coverage would probably be smaller than the estimate of the number of people who would receive the tax credit.
If Trumps tactics have been any indication, you can now ignore any reports about decreasing coverage, increasing cost, and tanking the federal budget simply by saying it's a "politically motivated fake report" and a good chunk of your supporters will go right along with you. I'm not sure how people can combat this when actual, hard data no longer matters when making decisions about whether or not something will be bad for the people.
Can anyone verify whether or not some form of this regulation did indeed exist before the ACA?
It did not at the national level, which is one reason it was controversial. Before the ACA, the primary federal tool reinforcing employer-provided health insurance was tax incentives, and there was also a spotty patchwork of state-level mandate laws with various levels of enforcement.
Yonder wrote:If the ACA standard is sufficient then why was there Democrat pushback to letting the Exchanges reach across States?
Because insurance companies are largely regulated by state agencies and selling an insurance plan from one state to a consumer in another state means that the consumer's state regulatory agency would have to then allocate resources to provide oversight of other state's insurance company, which would lead to clashes and confusion between the two regulatory bodies. And none of that would protect the consumer.
Also, the ACA lets insurance companies sell across state lines. Doing so is so complex that no insurance companies have done so.
Honestly (and chiming in for myself, but as someone who works in a small subsidiary of a major non-health insurance carrier), the state approvals process for every insurance document, form, policy endorsement, etc., are generally seen as a huge pain in the butt, and one that can take months in some states even if there aren't any objections from regulators. Having that state-level oversight means that expanding offerings into a new state is a big process. I was personally hoping that the ACA would have lead to a change in that format; there have been some federal structural moves along with it, such as the Federal Insurance Office.
50 separate rules and process regimes is always going to be less efficient than one, and as alluded to above even when some regulations are made national, it's complex enough to prevent cross-state markets where they did not already exist.
It's very important to note that the situation with state-level regulation is not accidental. The various health insurance companies that have oligopolized the different states jealously guard their territories.
Republicans lawmakers have presented one of their replacement plans for the ACA and they've clear taken a page from Trump. They have the best plan possible. Their plan is to have other people make plans.
I wish I was joking. I'm not.
Wait. Wait. Wait. They want to give people more choice. They don't want a mandate. Mandates are bad. So what that guy just said was that one way they'll enroll more people is to automatically enroll you if you're eligible for a subsidy. So telling someone "enroll or you'll have X penalty" is bad, but just enrolling them automatically is super good? I'm confused. I'm not necessarily against automatically enrolling people (assuming the thing they're enrolled in is good, they can change the plan, and the they don't also get hit with an automatic bill), but the logic is super confusing.
However, if it's cool to auto enroll people in health insurance if they're eligible, then we can extend that and say that people should be automatically registered to vote if they're eligible, right?
Also, on the "states can keep Obamacare if they want" thing: does that mean an Obamacare as it exists right now, or a defunded version of Obamacare? And how do they think the decreased size of the risk pool will affect premiums of the states that choose to stay?
It's very important to note that the situation with state-level regulation is not accidental. The various health insurance companies that have oligopolized the different states jealously guard their territories.
I don't think that was the source of this, though. They are taking (smart) advantage of a political philosophy which says that state control should be the default for the US, and which has strong adherents in at least one of the parties. That's been around more than a century before health insurance even existed...
They need to get it right. Obamacare without the individual mandate and a *large* percentage of eligible people participating nationally is *fiscally* dead in the water. It simply will not work. And the primary way to reduce the number of people participating is to allow states to opt out.
I don't know what they are thinking of, although being able to avoid the coming fecal storm front by saying "We tried to fix it, it was those other bozos who screwed you!" comes to mind.
We are in the first months of an 8 year run towards single payer healthcare in the US.
They need to get it right. Obamacare without the individual mandate and a *large* percentage of eligible people participating nationally is *fiscally* dead in the water. It simply will not work. And the primary way to reduce the number of people participating is to allow states to opt out.
I don't know what they are thinking of, although being able to avoid the coming fecal storm front by saying "We tried to fix it, it was those other bozos who screwed you!" comes to mind.
We are in the first months of an 8 year run towards single payer healthcare in the US.
I really hope you're right because (at least long-term) all this mess we're going through and will be going through would have a lot of value. While I didn't want the "burn it all down" to happen, now that it *is* happening, I do want it to ultimately result in positive things.
I'm not at all opposed to strong state rights because in some cases they can protect against an oppressive federal government (kind of like California may be doing now), but I also believe there are things that do need to function on a federal level and healthcare is probably one of those things because it sucks living in a state where healthcare is considered a privilege for the wealthy rather than a right for all.
We are in the first months of an 8 year run towards single payer healthcare in the US.
We're in the first months of an 8 year run of systematically dismantling what little social safety net our country has.
We won't have single-payer healthcare. We'll be lucky if we see Medicare and Medicaid cut to hell, vouchered, and block-granted.
OG_slinger wrote:Robear wrote:We are in the first months of an 8 year run towards single payer healthcare in the US.
We're in the first months of an 8 year run of systematically dismantling what little social safety net our country has.
I think that's what he meant. 8 years of the solutions and stopgaps holding us back from the brink being eviscerated, followed by rock bottom and then the US finally choosing single payer.
Yep, the question is no longer whether or not we'll reach rock bottom because it seems almost inevitable now that we will, but instead what we are going to do about it when we get there.
I think that's what he meant. 8 years of the solutions and stopgaps holding us back from the brink being eviscerated, followed by rock bottom and then the US finally choosing single payer.
Conservatives will never "choose" a single-payer healthcare system regardless of how much practical and financial sense it makes. It'll be government run and therefore bad.
Democrats will have to control both Houses and the White House and will have to jam it through like Obamacare. Except the conservative pushback and FUD will be several orders of magnitude larger.
Wait. Wait. Wait. They want to give people more choice. They don't want a mandate. Mandates are bad.
This is the part where you're confused. They don't want to give people more choice. They just want to be the ones doing the mandating - the ones in control. Remember how the mandate was implemented in Massachusetts by a Republican, and a very similar framework was proposed by the Republicans well before Obamacare became a thing?
Obamacare without the individual mandate and a *large* percentage of eligible people participating nationally is *fiscally* dead in the water. It simply will not work. And the primary way to reduce the number of people participating is to allow states to opt out.
Obamacare is already fiscally dead in the water - it always was. So is single-payer, and any system that's based on giving people what they want with no thought to how it is going to be paid for. It wouldn't shock me at all to see the Republicans pushing single-payer now that they are in control. It's not about doing what's right, or even fiscally feasible, it's about who controls the loot and who doles out the goodies to get votes.
Isn't saying that single payer can't be paid for in flagrant violation of the (dozens of?) examples of countries having a single payer system and paying for it?
I think the modifier "any system that's based on giving people what they want with no thought to how it is going to be paid for." deals with that.
Single player can work but people can't just have what they want regardless of cost.
It's not about doing what's right, or even fiscally feasible, it's about who controls the loot and who doles out the goodies to get votes.
I don't agree with you often but I agree 100%.
Isn't saying that single payer can't be paid for in flagrant violation of the (dozens of?) examples of countries having a single payer system and paying for it?
Not at all. Most of those countries don't pay for it - they just keep going further and further into debt. In places where the debt runs out, like Greece, the system simply falls apart.
The first rule of economics - economics always wins. Always. You can vote and talk and scheme all you want, but eventually, economics will catch up with you. You can't get something for nothing forever.
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